Why the need to ask?

I don’t quite get why people feel the need to ask the who/what/when/why of scars. Especially when there are a number of them, and let’s face it, aren’t my most attractive feature. I mean, I can kinda understand when there’s one recent wound, and people ask as a curiosity/sympathy/”are you okay” type thing. But when there’s a number of old scars…

A couple of OT friends noticed the scars on my legs and asked how I got them. I shrugged, said “I don’t know” and looked away. We then had a Counselling and Group Work tutorial in which our tutor briefly spoke about self harm, how it’s a way to cope and is not necessarily a suicide attempt. Straight after our tutorial one of the friends then asked me whether it’s from self harm. I ignored her and said nothing, while the other friend laughed and joked “We just had the tutorial so now you’re asking about self harm.”

Later on in the day my friend then took it upon herself to ask again, remarking that she doesn’t understand how I don’t know how I got them, that even if she fell, a person wouldn’t get that many scars. “Oh my gosh, why do you keep asking?” I asked in a light-heartedly exasperated way.

That night I received a text from my other friend which said that she thought it was quite immature for our two other friends to be joking about self harm like that, she noticed I looked uncomfortable and she was sorry I had to experience that. This is a friend who knows I have mental health issues so she could probably infer the scars are actually from self harm. I texted back that I appreciated her message and that I imagined our two friends joked about it because they didn’t realise what they were joking about was actually the truth.

Many of my scars have faded over the years and I’ve had a lot of time to get used to them so their questions about it don’t really bother me all that much as I just brush it off. I’m at the stage where though it’s not something I want to announce to everyone I know, it’s also not something I go to great lengths to hide any more. What I don’t understand though is why people are insistent on knowing how someone got their scars. I know what may seem obvious to me and others who have or know someone who has self harmed isn’t so obvious to them. But even if the scars aren’t from self harm, why do they probe so much curiosity? To me they’re just scars and not a big deal.

That feeling from self harm *PT*

One or two bad days I could probably handle. I could use distractions, for example, painting.

And it did, to an extent, work. I’m obviously no artist but it was somewhat calming and therapeutic to express myself on canvas. In this case, it represented the tears I had cried over two days.

When it’s four bad days in a row though, forget it. Conflict with my father on top of a long uni day and stress over the workload and study resulted in an end to my two month streak of being self harm free. Two months would be a lot more impressive if I managed to resist the temptation despite having a rough ride. As it is, those two months went pretty well for me, and it was rare I felt the need to self harm. Unfortunately it only took four days of things not going so well for me to return to using old ways to cope.

Whether it’s a placebo effect or whether it’s the endorphins being released, I feel so much better now.The sharp sting of the blade and the blood dripping down my leg both calmed me and helped release the tension I was feeling, distracting me from my emotions and tears. And now that I’m reminded of how damn good this feels, gosh I just want to do it again.

Have you self harmed?

One of the things I dislike in therapy is when a psychologist asks how many times I’ve self harmed that week. Okay, I can kinda see how it’s relevant to gauge whether I’m still self harming or not. From their point of view, it means I’m still engaging in risky, self-destructive behaviours and therefore is an issue that still needs to be worked on. But at the same time, is it really that helpful to put so much focus into it? In my mind, it reinforces the belief that the only way to communicate how I’m feeling on the inside is to physically harm myself on the outside.

A topic that has come up in my appointments with D is rejection; how much  fear it, how much it upsets me, how much I try to avoid it. There is a fear within me that if I report I haven’t self harmed, the professionals will automatically assume everything’s okay. I am afraid of rejection and I am afraid that I will be told at one point or another that I don’t need to continue seeing them any more because I’m ‘cured’.

There’s been a few times D has asked me to record down when I’ve self harmed during the week for homework. I’ve never done what he’s asked. I don’t believe it will do me much good and may even trigger me more by making me think I have to self harm to prove I deserve help.

Shorts

It’s great when I don’t even have to think of an excuse for the scars I have from self harming. Instead, people come up with them for me! “Did you burn yourself with an iron?” my auntie asked me of the couple of scars on my arm, before she found out about my mentalness. Taken by surprise, I gave a vague “mmmmm” in response. More recently in Indonesia, I was again questioned on my scars. This time by my uncle, asking if I got burnt by a frying pan. “Nope, by an iron,” I told him, using my auntie’s ready made explanation.

When I was in the private mental health unit in May, I met another patient who was about the same age as me. She had scars all up and down both arms yet she still wears t-shirts and singlet tops same as everybody else. We got talking about self harm and scars one day. “People aren’t actually that bad,” she told me. “There was one person who stared,” she said, “But other than that most people are fine.”

The two coupled together, and I think I may be a little bit braver. This summer season I bought shorts.  Prior to this season, last time I did was way back in 2008. And as long as I don’t have recent wounds on the show, I wear them too. The shorter ones I only wear with stockings. The slightly longer one I wear by itself. It covers most scars when I’m stood upright, but rides up to reveal scars when I’m sat down. I think I’m okay with that. Others don’t have to be. I’ll never be able to wear the denim underwear that is so popular with 15 year old girls these days. But then again, why would I want to? I’m just happy to be back out in non knee-length shorts, the first time in about three years.

Proof I’m struggling

Last week the hospital psychologist I’m seeing, D, asked me to list the reasons/benefits of self harming. Besides the usual reasons; it distracts me from my emotions, it’s a way of punishing myself, it’s a way of releasing anger and frustration, etc. etc., I also said that it’s a way to “prove that I’m struggling.” He briefly brought that up during our session today.  He told us that the people who have treated us badly or abused us rarely feel guilt and the need to make it up to us. If years later we’re struggling, they’re not going to see it as they’re the ones to blame. Instead, they’re going to see it as we’re the ones who don’t have the willpower to get ourselves out of this. D told me a story about a Vietnam war veteran who spent thirty years on his porch drinking, telling people that the government had done him over. He also told me of a previous self harmer who was the victim of a paedophile ring and is now a counsellor, one of the things she said is that the best revenge is to make a success of yourself.

Objectively I can see his point. Looking in from the outside at these situations, I can see that destroying yourself to spite those who’ve wronged you is pointless. It doesn’t affect them and it’s letting them win. But when it’s you in that situation, it’s harder to have this insight. And when we’re engaging in these self-destructive behaviours, we’re not exactly thinking, “This’ll teach them!”

It’s also more than that. “We know you’re struggling,” D said to me. But do they really? I feel like if there’s no physical proof, people won’t believe me. I struggle with verbalizing how I feel. The closest I get to admitting I’m struggling is responding with “Umm, not that great…” when a mental health professional asks how I am. In a way, self harming acts as a voice, ‘proof’ I’m struggling. Then there’s the reaction to my scars by the few who have seen them; the first GP I saw, doctors and nurses in the emergency department, a doctor and nurse in the psych ward. Yes some of them have reacted with shock and revulsion. But there’s a part of me that feels satisfied I’ve done a proper job of it when what they do or say makes me suspect they’re thinking, “This girl really does have issues.”

Last week D also brought up that if I’ve stopped self harming, I could get the plastics people to have a look at my scars. Immediately my anxiety went up. I realised the absence of scars is another one of the barriers stopping me from ceasing to cut myself. As much as I dislike not being able to wear certain shorts, skirts, dresses and bathers, it scares me a whole lot more not to have something to show for my struggles.

Self harming in hospital, a ‘big deal’ apparently

I wish I could verbalise what’s in my head instead of keeping it locked up inside.

I wish I could be honest about how I’m feeling.

I wish I had the courage to ask for help when I need it.

I self harmed yesterday. To be honest, I’ve been self harming throughout my time here. Even when I was on specials, I cut myself the one time the nurse wasn’t watching me, in the shower. It’s just that yesterday the psychologist asked why I was crying the previous day. I admitted I had cut myself both the day before and that day. “Can you show me?” he asked. I said to him it was on my thigh and he spotted the patch of blood that was seeping through my jeans. I told him I did it half an hour ago when he asked, and he went off to tell the nurses.

One of the doctors on my team came to see me and to look at the cuts. They weren’t deep. As expected, I had my blade taken away from me and was also placed on 15 minute obs.

The registrar came to speak with me today. She tried to explain why self harming is a big deal to them. Infection, septicaemia, cutting a major artery, it’s not a ‘normal’ way of coping… In turn, I tried to explain why self harming isn’t a big deal to me. I’ve done so for about seven years now and they’ve never been all that deep. She spoke of staying here until I learnt a different strategy to cope instead of self harming. My tears almost turned into laughter then. If that’s the case I’ll be here for years… I informed her my exams are next week on Wednesday, Thursday and Friday. Told her with uncertainty I want to be discharged, as it’s easier to study at home rather than on the ward. She’ll speak to me about what the plan is tomorrow apparently.

It’ll be four weeks in this public psych ward on Sunday, and now there are only two other patients who were here when I arrived.

20

Yesterday the nurse spotted where I had scratched myself on the arms.

Yesterday I had my share of the room and all my belongings thoroughly searched by two nurses.

Yesterday they took away everything they considered sharp, as well as all phone and laptop chargers.

Yesterday they found my blade as well as a drawstring I had fashioned into a noose.

Yesterday I was put on specials, which means a nurse is within a few metres away from me every minute of the day.

Yesterday they just kept giving me PRN medication; 3 doses of lorazepam and a dose of Seroquel.

Yesterday I also turned 20. Happy birthday to me, huh?

Self harming in hospital

I’m not really trying and I know it. Yet I just can’t seem to help myself. The mental health resource book they want us to read? I already own it from my psych ward admission last December. CBT group where they went through the unhelpful thinking styles? Already did that way back with my first psychologist. Come find my nurse if I want to harm myself? There’s just something stopping me from being able to do so. My nurse this afternoon described it as me ‘putting up a wall’ when she tries to talk to me. It doesn’t help either that she is merely a year older than me. Being only nineteen, it’s not something I’m accustomed to. It just doesn’t seem right there’s such a big power difference when we’re practically the same age and I can’t help feeling some resentment.

I tried to do the right thing by not bringing my blade in, but it’s just been so hard not having the means to self harm when I’ve had the urge. Stole a knife from the OT kitchen during the cooking group. I didn’t think they’d notice, but the OT came questioning the for of us who attended almost as soon as we returned to the ward. Was asked twice by the OT, once by the OTA and once more by the nurse if I knew anything about it. Looked them in the eye, lied straight to their face and said no. Shouldn’t have even bothered to take it, was too blunt to do much anyway. Felt guilty, confessed and turned it in to the nurse the next day.

Today however, I went off the ward without telling anyone. I was only gone for about an hour, but they noticed. So where did I disappear to? The shops to buy blades… And have finally relieved the urge to self harm that’s been there for days….despite my assurances of “Yes, yes, yes,” when asked, “Are you safe?”

Met the consultant yesterday, prior to that I had only met the registrar. Asked when I’d be discharged, was told I’d see the clinical psychologist on Monday and be ‘assessed,’ and not given an answer to my question.

Anatomy labs

I attended the orientation session for my semester two classes yesterday. I was dismayed to find that for our Anatomy labs, we are going to have to use each other as models to facilitate learning palpations. And no, I didn’t spell that incorrectly, as was suggested by Google. Palpation is defined as: To examine or explore by touching (an organ or area of the body), usually as a diagnostic aid.

While I can’t say I’m keen on the idea of being groped and poked and prodded by my fellow classmates, that’s not the worst part either. The worst is that we’ve been told we must wear ‘singlets and shorts’ during these labs and jeans and trackies are a no go. This is so we are able to feel each other up palpate and draw on each other where certain muscles, bones and ligaments are and learn ridiculous names such as extensor hallucis longus muscle. Um, yeah. Shorts and me do not go well together. I’ve had even doctors and nurses express horror at the scars on my thighs; purplish-red, raised and too many to count. I’d hate to imagine how mere inexperienced first year students would react. Leggings or knee-length shorts better make the cut because there’s no way I’m wearing anything exposing more than that.

And you thought all OTs needed to know was how to tell patients in a psych ward to go tend some pot plants or string beads together to make a necklace…

The last of my pills

My mother claims that she came into my room to ‘tidy up my desk’ while I was out. Right. Because the first thing one does in tidying a desk is to pull open and rifle through the drawers. That’s how she came to find the box of escitalopram and sertraline I still had in my possession. And my desk is still as messy neat as it was before I left for the day. 

I was confronted by my mother as soon as I arrived home, when she came into my room, pulled open my drawer and enquired about the two boxes of medication I had. I tried to claim they were ‘left over’ from when I still took the aforementioned medications. Except she pointed out the date written on the dispensing label of my box of sertraline. 24 June 2011. Caught out. She confiscated the two boxes and asked for the script. I gave her the one for escitalopram, leaving the one for sertraline. She came back two minutes later realising, and asked for the sertraline script too. Caught out again.  

I feel as though nobody understands how much more desperate and determined to OD that makes me. I’m left with no more antidepressants and no more scripts in my possession. Similar to some people needing their blade there as a safety blanket in case they have the urge to cut, I need those pills in case I have an urge to self harm by ODing. Yeah, I could OD on something like paracetamol, but then I’d have to go to hospital afterwards for treatment to prevent liver damage. With the SSRIs, I know I can OD without needing hospital treatment. I’ve done it a fair amount of times and recovered at home. I don’t want to self harm and end up in the Emergency Department, I want to self harm without; ending up on a hospital bed, my parents finding out, having a cannula stuck up my arm, adding another OD to my hospital records, being labelled as a ‘psych patient’ and undergoing an assessment by ED psychiatrists.

I’m lucky that my mother didn’t find the good stuff. The stuff that has a much more likely chance of killing me. The stuff I had the sense to hide a little better. The stuff that required some effort to obtain. The stuff I wouldn’t take unless I was really sure I wanted to go. But that’s my ‘suicide stuff.’ I’m still angry, embarrassed and upset that I had my ‘self harm stuff’ taken away from me.